Foreign body in the uterus symptoms. Foreign body in the uterus. Prevention of foreign bodies entering the vagina

To foreign bodies in the uterus   include intrauterine contraceptives (IUDs) and their fragments, bone fragments of the fetus, various ligatures.

Clinic. The clinical picture of foreign bodies in the uterine cavity is most often manifested by various disorders of menstrual function (menorrhagia, menometrorrhagia, acyclic blood discharge). With a prolonged stay of a foreign body in the uterus, secondary infertility, chronic endometritis or pyometra are possible. A foreign body in the uterine cavity (fragments of the IUD) may remain asymptomatic.

Pain syndrome   accompanies perforation of the uterus of the IUD and its further migration to neighboring organs with possible perforation. Migration of the IUD into the omentum, rectosigmoid angle of the colon, retroperitoneal space, bladder, into the cecum, to the region of the appendicular process, into the small intestine, to the uterine appendages is not excluded.

Bone fragments usually become an accidental find in patients with menstrual irregularities, prolonged endometritis, or secondary infertility. With a careful collection of anamnesis, abortions are detected in a long period (13-14 weeks or more), complicated, as a rule, by prolonged bleeding, sometimes with repeated curettage of the uterine cavity.

Ligaturesas a rule, silk or lavsan, are detected in patients with chronic endometritis and a pyometra with cesarean section or a conservative history of myomectomy. These patients complain of persistent purulent discharge from the genital tract, not amenable to massive antibacterial therapy, and secondary infertility.

Diagnostics. The main diagnostic method for foreign bodies in the uterus is hysteroscopy. All others (ultrasound, laparoscopy if necessary) are auxiliary.

Ultrasound The ultrasound picture with IUD depends on its shape and type. Each type of IUD gives a characteristic and clear echogenic image, depending on the location of the IUD in the uterus. In the optimal situation, the leaf part of the IUD is localized in the bottom, while the proximal part does not reach the level of the internal pharynx.

With pathological displacement of the IUD its proximal part is visualized in the upper third of the cervical canal. The most serious complication of IUD is uterine perforation. It can be incomplete (IUD penetrates the myometrium) or complete (IUD partially or completely extends beyond the uterus).

Fragments of the IUD can be determined both in the uterine cavity and in the myometrium in the form of linear inclusions of sharply increased echogenicity and various sizes.

Accurate ultrasound diagnosis of bone fragments is difficult. With ultrasound, they can be determined in the form of disparate echo-saturated structures of irregular shape.

Ultrasound with ligatures in the uterine cavity is uninformative.

Hysteroscopy. The endoscopic picture of the IUD depends on its type and time of the study. With a prolonged stay of the IUD in the uterus, it is partially covered by synechia and endometrial flaps, salt crystals. Perhaps the formation of pressure sores on the wall of the uterus. If fragments of the IUD are suspected, hysteroscopy should be performed in the early proliferation phase, carefully examining all the walls of the uterus. Fragments of the IUD can be the remains of a fragmented plastic part, metal debris, a "mustache" and can either be freely located in the uterine cavity or partially embedded in its wall. If perforation of the uterus of the IUD is detected, hysteroscopy is performed together with laparoscopy.

Hysteroscopy is performed when fragments of the IUD remain in the uterine cavity due to its unsuccessful removal and there is a suspicion of perforation of the uterus of the IUD. A prolonged stay of the IUD in the uterine cavity sometimes leads to its tight attachment and even growth into the myometrium. Attempts to remove fragments of the IUD in such situations are unsuccessful. Hysteroscopy allows you to determine the localization of the IUD or its fragments and to accurately remove these foreign bodies.

The hysteroscopic picture of bone fragments depends on the duration of their stay in the uterus. If the period is relatively short, then lamellar dense whitish formations with sharp edges are visible, invading the uterine wall. When you try to remove them, bleeding often begins. If bone fragments have been in the uterine cavity for a long time (more than 5 years), they have a characteristic crystalline structure (coral shape) and, when attempted to be removed with forceps, they scatter like sand. Bone fragments are more often located in the area of \u200b\u200bthe mouth of the fallopian tubes and the bottom of the uterus.

Ligatures during hysteroscopy are defined as whitish threads against the background of general hyperemia of the uterine mucosa in its lower third along the anterior wall (after cesarean section) or in different areas (after conservative myomectomy)

Treatment. Foreign bodies are removed from the uterus by hysteroscopy using special endoscopic instruments. It is not recommended to try to remove the IUD without a visible "mustache" blindly, with various devices. Such attempts usually lead to deformation and fragmentation of the IUD, and sometimes to uterine perforation. If there is a suspicion of perforation of the uterus of the IUD, hysteroscopy and laparoscopy are performed together.

If, according to the ultrasound data, fragments of the IUD are determined in the thickness of the myometrium and cannot be determined with hysteroscopy and laparoscopy, one should not try to extract these fragments from the wall thickness. Further monitoring of the patient is necessary.

In the postoperative period after removal of a foreign body from the uterus, antibiotic therapy is recommended taking into account the sensitivity of the flora to the drug.

If a woman realizes that something is wrong in her genitals, she does not wait for clinical signs, but turns to a gynecologist or goes to the nearest hospital in the evening.

Sometimes, due to individual anatomical features - a wide vagina, a woman for a long time does not suspect the presence of a foreign body in it, which is typical for the traumatic etiology of a foreign body, or prolapse of the uterine ring. Or just in the bustle I forgot about the swab, which is swollen. Pain can appear only during intercourse or a random object is detected during a gynecological examination.

The presence of foreign objects in the vagina for a long time causes inflammation of the organ - vulvovaginitis: discharge with an unpleasant odor appears, a constant burning sensation, and sometimes pain.

Possible formation of pressure sores of the vaginal mucosa, necrosis of the wall - necrosis, ulceration. Possible increase in body temperature due to the spread of infection in the uterine cavity and the development of endometritis. Often a urinary tract infection develops - cystitis, pyelonephritis.

What should a woman do?

The main rule is, if a foreign object does not fall out by itself, in no case should you try to pull it out of the vagina, especially with the use of improvised tools or locksmith tools. You can damage the mucous membrane and even perforate - pierce the wall of the vagina. Or push it deeper and deeper. Along the way, bring an infection, after which you will have to be treated for a long time.

You need to go to the gynecologist, there is no other solution to this problem.

How is a foreign body removed?

When viewed on a chair, a doctor with the help of a gynecological mirror widening the entrance to the vagina, or with the help of colposcopy, or even a finger examination, discovers a foreign object.

• If the subject is not deep, then it is squeezed out with your fingers, including helping the process through the wall of the rectum
• Use forceps, tweezers or clamps to retrieve deep objects
• Vaginal lavage is used to remove many small items and fibers.

Hello Yulia!

If you are sure that a small particle of the object broke off during masturbation, and not earlier, and remained in the genital tract, you should make every effort to remove the foreign body.

It is impossible to predict how a foreign body behaves in your body. Once in the vagina, a piece of plastic can not cause any disorders and pathological symptoms for a long time, can go out with natural secretions, or, conversely, go deep into the uterus and further, with the most unpleasant consequences for health.

In some cases, you can remove a foreign object from the vagina yourself using your fingers, irrigation, or forceps. But this is only if the foreign body is not deep in the vagina and is determined by palpation. It all depends on where the foreign body originally got, if it caused damage to the epithelium and mucous surfaces, and also on the size and shape of the foreign body.

In difficult cases, the assistance of specialists may be required to retrieve the item and prevent infections.

The ingress of foreign objects into the genital tract is dangerous due to the possibility of the development of bacterial infections, inflammations, and a change in the natural microflora.

The presence of a foreign body in the vagina can be manifested by symptoms of vulvovaginitis - leucorrhoea, hyperemia of the vestibule, burning, spotting.

Carefully monitor your condition and the nature of the discharge. You should be alert for discharge with an unpleasant odor or unusual color. Sometimes the presence of a foreign body can cause vaginal bleeding. In this case, you should immediately consult a doctor.

With a long stay of a foreign body in the vagina, erosion can develop. Sharp objects can lead to tissue perforation and the development of a secondary infection.

Diagnosis of a foreign body depends on the length of time the object has been in the vagina, and includes gynecological examination, colposcopy, vaginal probe, smear examination.

If a foreign body is suspected to migrate from the vagina, the doctor may use computed tomography, a scan, or an x-ray of the abdominal cavity for diagnosis. Also, ultrasound imaging may be required to locate a foreign body in the vagina and pelvis.

Treatment consists in retrieving the detected object using a finger, irrigation, tools, or surgery.

The easiest and most effective way to remove a foreign body is to remove it with urethral forceps or tweezers after visualization with the help of mirrors.

All symptoms of infection, pain, and discharge usually go away quickly after a foreign body is removed.

In the case of a long stay of foreign objects in the genital tract and the formation of infection, antibiotics can be prescribed.

The most serious complications arise when infection penetrates into the deep pelvic tissue or peritoneal cavity.

Therefore, it is better not to risk your health and seek the help of a gynecologist.

Content

If a foreign body is detected in the uterine cavity, surgical treatment is required. This problem cannot be ignored. Indeed, in the presence of foreign objects, a woman in the internal organs develops bedsores, necrosis, suppuration and sepsis - these conditions are life-threatening. Perforation of the uterine walls is possible.

Foreign bodies

In the process of diagnosis, doctors sometimes reveal that a woman has various foreign objects in her uterus after interventions. Among them there are:

• intrauterine contraceptives or parts thereof (metal debris, plastic coat hanger, threads);
• fragments of the fetus (bone parts);
• operational ligatures.

There are situations when, when muscles contract, foreign bodies begin to move: they can perforate the wall of the uterus and end up in the abdominal cavity, retroperitoneal space, and migrate to other organs. Foreign bodies in the uterus may remain after rape.

Symptoms

Foreign objects located in the uterus are sometimes encapsulated. In this situation, a woman will not have any symptoms for a long time. But more often, foreign objects provoke the onset of the inflammatory process. It cannot be stopped by conservative therapy.

Women with foreign bodies in the uterine cavity, most often they come to the gynecologist with complaints of menstrual dysfunction and pain.

In patients, menstruation becomes plentiful and prolonged, blood loss exceeds the standard norm of 150 ml. Many talk about the appearance of intermenstrual bleeding. With a long stay of a foreign object in the uterus, the patient may begin:

• chronic endometritis (inflammation of the internal mucous layer of the uterus);
• pyometra (accumulation of pus in the uterine cavity);
• secondary infertility.

The development of these pathologies often begins due to lavsan or silk ligatures remaining in the uterine cavity after surgery. They provoke the appearance of purulent discharge, which does not decrease even against the background of antibiotic therapy. A history of these patients had a cesarean section, conservative myomectomy, or other uterine surgery.

Severe pain more often occurs if an intrauterine contraceptive device or individual fragments remain inside. They appear when the migration of these objects to the following anatomical areas begins:

• appendages;
• intestines (into the cecum to the appendix, into the small intestine or rectosigmoid angle of the large intestine);
• retroperitoneal space;
• stuffing box.

Migrating parts of intrauterine contraceptives can lead to perforation of not only the walls of the uterus, but also of the organs into which they enter.

With secondary infertility, cycle disorders, endometritis, discomfort and pain in the lower abdomen, bony remains of the fetus can be detected. A history of such women reveals spontaneous abortion or abortion for a period of more than 12 weeks. Often such abortions and miscarriages were complicated by prolonged bleeding, and additional curettage was performed on the patients.

If bone fragments in the uterus are more than 5 years old, then they take a coral shape. When you try to pull them out, they crumble into small pieces.

Diagnostics

You can detect a foreign body in the uterus using hysteroscopy. As methods of auxiliary diagnostics use:

• laparoscopy
• sounding;
• visual inspection on the armchair.

Hysteroscopy is a method of examining the uterine cavity using a special optical device that is inserted through the cervical canal. Foreign bodies are located mainly at the bottom of the uterus.

How the uterus will look from the insidedepends on which particular foreign body remains in its cavity. The hysteroscopic picture varies depending on the length of time the objects were located.

If foreign bodies have been in the uterus for a long time, then they can partially become covered by intrauterine synechia, endometrium, calcium deposits. Sometimes, because of them, pressure sores are formed in the walls of the muscular organ. It is possible to identify fragmented plastic parts, "mustache", metal debris. They are freely located in the cavity or are embedded in the wall of the uterus.

Also, with hysteroscopy, intrauterine contraceptives are removed, which, due to a long stay inside, have attached or even grown into the myometrium. When performing this diagnostic and treatment procedure, you can accurately determine the location of foreign objects and remove them accurately.

With the help of ultrasound, you can find the remains of intrauterine contraceptives. If the contraceptive has shifted, then its proximal part can be found in the cervical canal (in its upper third). But bone fragments and ligatures in this study are practically invisible. True, parts of the bones can be visualized as scattered echo-saturated structures that differ in irregular shape.

Treatment

When identifying foreign bodies, the doctor selects the optimal method for their removal. Most often, fragments are removed immediately during hysteroscopy using endoscopic devices.

Intrauterine contraceptives are not recommended to be cleaned blindly using various tools, unless their "mustache" is visible. With such attempts, contraceptives are often deformed, divided into fragments. The possibility of perforation of the uterine walls cannot be ruled out.

In cases where the doctor suspects what has happened, it is necessary to simultaneously conduct hysteroscopy and laparoscopy.

Sometimes, using ultrasound diagnostics, it is revealed that there are fragments of foreign bodies in the myometrium. But during joint hysteroscopy and laparoscopy, they are not always able to be detected. In such situations, trying to find these fragments empirically in order to remove them is not recommended. Experts advise to monitor such patients.

If a foreign object has grown into the body of the uterus, it can carry out curettage. The operation technology resembles an abortion. In the most advanced cases, an extravaginal dissection of the uterus is required. When parts of intrauterine contraceptives migrate to other cavities and organs, a laparotomy is performed.

After the completion of surgical treatment and removal of a foreign object, antibiotic therapy is prescribed taking into account the sensitivity of microflora to drugs.

It is possible to prevent the development of diseases and perforation of the uterine walls when foreign bodies enter the uterus if you monitor the condition of a woman after removal of intraventricular contraception, abortion, cesarean section and myomectomy.

Not every woman understands where exactly the organs of her reproductive system are located. Therefore, when pain occurs, women often can not understand what is bothering them. Many of them do not know where the uterus is located. But this is one of the most important organs of a woman, performing many functions. Will consider this question in more detail.

The structure and physiological changes of the uterus

The pelvic cavity is where the uterus is located. It is located in the lower abdominal region. What does the uterus look like? Normally, it looks like an inverted pear. This is a cavity organ, the wall of which consists mainly of muscle tissue up to 3 cm thick. The bladder is located in front of it. The back is in contact with the front surface of the rectum.

The pelvic and uterine axis are in the same plane, which is considered normal. In addition, it may not match slightly. This is also not a pathology, and does not require action.

The location of the uterus is affected by ligaments located on the sides and performing the function of holding it in the required position. Pathology is a strong deviation of the organ from the axis of the pelvis. It can fall, fall out, settle down behind the rectum, bend.

The weight of the uterus in a nulliparous woman does not exceed 50 grams. After the birth of a child, it increases one and a half to two times, reaching 100 g. In addition, the size of the organ is important. Its length in women without children is about 7 cm and a width of 4 cm. During the bearing of the baby, the uterus is stretched. After childbirth, its contraction occurs, but to the previous size it no longer decreases. The longitudinal and transverse dimensions increase by 2-3 cm.

The uterus consists of the bottom, body and neck. The bottom is the area located above the conditional line passing through the fallopian tubes. The body of the organ in the section of a triangular shape, starts from the bottom and continues to the uterine narrowing.

The cervix is \u200b\u200ba continuation of the previous part and makes up the rest of the uterus. It opens into the vagina and consists of three parts - the front, back and the segment located above the vagina. The latter in women without children resembles a cut cone, and in those giving birth it has a cylindrical shape.

Inside the neck, a layer of epithelium covers. The part that is visible in the vaginal cavity is covered by a stratified squamous epithelium, not prone to keratinization. The remaining segment is lined with glandular epithelial cells.

The place of transition of one species to another is of great clinical importance. In this area, dysplasia often occurs, which, if untreated, can transform into a cancerous tumor.

The frontal section of the organ looks like a triangle. Its acute angle is directed downward. On each side, the fallopian tube opens into the uterus. The base of the triangle passes into the cervical canal, preventing the release of mucus, which is produced by the glandular epithelium. This secret has an antiseptic property and kills bacteria heading into the abdominal cavity. The neck channel has two openings. One protrudes into the uterus, the second into the vaginal cavity.

The cervical canal is round or resembles a transverse fissure. The place where the body goes into the neck is called the isthmus. Here, the woman’s uterus is often torn during the maternity process.

The uterine wall has three layers: the outer one is the serous membrane, the middle one is the muscle fibers that are the basis of the organ, and the inner one is the mucous membrane. In addition, the parametrium is isolated - this is fatty tissue, which is located in front and side of the uterus, in the space between the sheets of the largest ligament. It contains vessels that provide organ nutrition.

Sex hormones affect contractility. It is the muscle layer that provides the birth of a child. Also, a certain role in this process is played by the internal pharynx and isthmus.

The mucous layer (endometrium) is covered with epithelial cells. It is smooth and divided into two sublayers. The surface sublayer has a variable thickness. Before menstruation, it is rejected, which is accompanied by bleeding.

The surface layer is also important for bearing the fetus. A fertilized egg is fixed on it. The basal sublayer is, as it were, the base of the mucous layer. Its function is to ensure restoration of the surface epithelium. It contains tubular glands reaching the muscle fibers.

The serous membrane is the outer covering layer of the woman’s uterus. She lines the muscles of the bottom and body outside. On the sides it passes to other organs.

Near the bladder forms a vesicoureteral depression. Connection with it is carried out through fiber. Behind the peritoneum passes to the vagina and rectum, forming a rectal-uterine depression. It is closed by serous folds, which consist of connective tissue cells. They also have some smooth muscle fibers.

The functions of the uterus and deviations in its structure

The main function of a woman’s uterus is the ability to bear the fetus. It is provided by the muscles of the middle layer. It has smooth muscle fibers that are intertwined with each other. This structure allows the muscles to stretch during pregnancy, as the fetus grows. In this case, there is no violation of tone.

The female uterus and ligaments surrounding it are supplied with blood by the uterine and ovarian arteries. The outflow is carried out by the venous uterine plexus, which is located in a wide ligament. From it, blood flows into the ovarian, uterine and internal sacral veins.

During the period of gestation, these vessels can expand significantly, providing absorption of placental blood. Lymph flows into the external iliac and inguinal nodes. Innervation is carried out by many nerves.

In addition to ensuring implantation and development of the fetus, a healthy uterus performs the following functions:

• protects other organs of the pelvic cavity from infection through the vagina;
• provides menstrual function;
• participates in sexual intercourse, creating conditions for the fertilization of the egg;
• strengthens the bottom of the pelvis.

Along with the uterus of a normal (pear-shaped) form, abnormal species are also found. They include:

A one-horned uterus is found in every tenth woman with an abnormality. It is formed as a result of a slowdown in the growth of the Muller ducts on one side. Half of the patients with this diagnosis cannot have children. They also experience pain during intimacy.

The two-horned uterus develops due to incomplete fusion of the Mullerian ducts. Often it is double-celled. In rare cases, two cervixes are observed. The vagina sometimes has a septum. In appearance, such a uterus resembles a heart.

The saddle shape is quite common. In this case, a saddle-shaped depression is formed in the bottom. Such an abnormal structure often does not produce any symptoms. May occur during pregnancy. Sometimes patients with a saddle uterus carry a child without problems. But there are miscarriages or premature births.

A double uterus usually does not cause much trouble. At the same time, the presence of two vaginas can be observed. Fetal development is possible in both uterus.

A uterus is considered small, the length of which does not exceed 8 cm. At the same time, the proportions of the body and neck, as well as all the functions of the uterus, are preserved.

The infantile uterus has a length of 3-5 cm. The ratio of the body to the neck is incorrect, the latter is elongated. The rudimentary uterus is the remains of an organ that in most cases does not fulfill its function.

The uterus is one of the main organs of the female body. In her cavity, fertilization and development of the unborn child occur. Due to this, it actually ensures the continuation of the genus.